Bilateral Amputation Research Articles

Assessment of Quality of Life in Patients with Lower Limb Amputation after Work Accidents

Amputation is the intentional removal, by surgery, of a limb segment or part of the body. By increasing the degree of urbanization and automation around the world, accidents are the most important cause of morbidity and mortality. Lower limb amputation is a life-changing event and has an impact on functional, work, social and recreational activities. Amputation can lead people to lose self-esteem, independence and work. Quality of life it is as a wide range of human experiences related to one's general well-being. For the specific psychosocial and functional testing of people who have undergone an amputation TAPES is more frequently used. The study included 7 patients with amputation of lower limbs, prostheses, who underwent unilateral or bilateral amputation of traumatic genesis at work. Patients filled in the Trinity Amputation and Prosthesis Experience questionnaire in order to estimate quality of life and Rosenberg scale to assess self-esteem. The adaptation to wearing the prosthesis is reported by 71.42% and more than 50% of the subjects are satisfied with their prosthesis. The factors with the greatest impact on functional abilities proved to be: the level of amputation, the duration of living with the amputation limb, the presence of other pathologies and psycho-emotional status. Medical rehabilitation programs improve the functional and psycho-emotional abilities of patients with lower limb amputations.

Strategies employed in coping with physical disabilities acquired during adulthood in rural South Africa.

BackgroundSociety places people with physical disabilities acquired during adulthood in disadvantaged positions, especially when they cannot participate in activities like their non-disabled counterparts. The situation can be worse for individuals who acquire disabilities during adulthood, where they have to learn to cope with the adulthood-acquired physical disabilities.ObjectivesThis study aimed to identify the types of physical disabilities acquired during adulthood and their causes and explore how participants defined their disabilities and the coping strategies they used.MethodsThe study used a phenomenological research design. Five adults (three women, two men) with adulthood-acquired disabilities were purposefully selected from a rural area in Limpopo, South Africa. Data were collected using semi-structured interviews. Thematic analysis was used to generate themes about coping strategies study participants used.ResultsThe results show four types of adulthood-acquired disabilities amongst the participants: visual impairment, paraplegia, weakened muscles which led to bilateral amputation, loss of function on both hands and legs. Participants’ meanings of their physical adulthood-acquired disabilities ranged from a punishment, pain, not a bother, black magic, to results of doing wrong things to someone. In coming to terms with their adulthood-acquired disabilities, participants used problem- and emotion-focused strategies. Four themes from the participants’ responses were spiritual support, social support, substance dependency, access to health and rehabilitation services.ConclusionThe study contributes to understanding the experiences of individuals who acquired disabilities in adulthood, how they define their disabilities and the divergent coping strategies they use. This study established that participants used problem-focused, positive emotion-focused and negative emotion-focused coping strategies.

Artificially long legs directly enhance long sprint running performance.

This comment addresses the incomplete presentation and incorrect conclusion offered in the recent manuscript of Beck et al. (R. Soc. Open Sci. 9, 211799 (doi:10.1098/rsos.211799)). The manuscript introduces biomechanical and performance data on the fastest-ever, bilateral amputee 400 m runner. Using an advantage standard of not faster than the fastest non-amputee runner ever (i.e. performance superior to that of the intact-limb world record-holder), the Beck et al. manuscript concludes that sprint running performance on bilateral, lower-limb prostheses is not unequivocally advantageous compared to the biological limb condition. The manuscript acknowledges the long-standing support of the authors for the numerous eligibility applications of the bilateral-amputee athlete. However, it does not acknowledge that the athlete's anatomically disproportionate prosthetic limb lengths (+15 cm versus the World Para Athletics maximum) are ineligible in both Olympic and Paralympic track competition due to their performance-enhancing properties. Also not acknowledged are the slower sprint performances of the bilateral-amputee athlete on limbs of shorter length that directly refute their manuscript's primary conclusion. Our contribution here provides essential background information and data not included in the Beck et al. manuscript that make the correct empirical conclusion clear: artificially long legs artificially enhance long sprint running performance.

Concordance between bio-impedance analysis and clinical score in fluid-status assessment of maintenance haemodialysis patients: A single centre experience.

BACKGROUNDThe burden of chronic kidney disease (CKD) is rising rapidly globally. Fluid overload (FO), an independent predictor of mortality in CKD, should be accurately assessed to guide estimation of the volume of fluid to be removed during haemodialysis (HD). Clinical score (CS) and bio-impedance analysis (BIA) have been utilized in assessment of FO and BIA has demonstrated reproducibility and accuracy in determination of fluid status in patients on HD. There is need to determine the performance of locally-developed CSs in fluid status assessment when evaluated against BIA.AIMTo assess the hydration status of patients on maintenance HD using BIA and a CS, as well as to evaluate the performance of that CS against BIA in fluid status assessment.METHODSThis was a single-centre, hospital-based cross-sectional study which recruited adult patients with CKD who were on maintenance HD at Kenyatta National Hospital. The patients were aged 18 years and above and had been on maintenance HD for at least 3 mo. Those with pacemakers, metallic implants, or bilateral limbs amputations were excluded. Data on the patients’ clinical history, physical examination, and chest radiograph findings were collected. BIA was performed on each of the study participants using the Quantum® II bio-impedance analyser manufactured by RJL Systems together with the BC 4® software. In evaluating the performance of the CS, BIA was considered as the gold standard test. A 2-by-2 table of the participants’ fluid status at each of the CS values obtained compared to their paired BIA results was constructed (either ++, +-, -- or -+ for FO using the CS and BIA, respectively). The results from this 2-by-2 table were used to compute the sensitivity and specificity of the CS at the various reference points and subsequently plot a receiver operating characteristic (ROC) curve that was used to determine the best cut-off point. Those above and below the best CS cut-off point as determined by the ROC were classified as being positive and negative for FO, respectively. The proportions of participants diagnosed with FO by the CS and BIA, respectively, were computed and summarized in a 2-by-2 contingency table for comparison. McNemar’s chi-squared test was used to assess any statistically significant difference in proportions of patients diagnosed as having FO by CS and BIA. Logistic regression analysis was conducted to assess whether the variables for the duration of dialysis, the number of missed dialysis sessions, advisement by health care professional on fluid or salt intake, actual fluid intake, the number of anti-hypertensives used, or body mass index were associated with a patient’s odds of having FO as diagnosed by BIA.RESULTSFrom 100 patients on maintenance HD screened for eligibility, 80 were recruited into this study. Seventy-one (88.75%) patients were fluid overloaded when evaluated using BIA with mean extracellular volume of 3.02 ± 1.79 L as opposed to the forty-seven (58.25%) patients who had FO when evaluated using the CS. The difference was significant, with a P value of < 0.0001 (95% confidence interval: 0.1758-0.4242). Using CS, values above 4 were indicative of FO while values less than or equal to 4 denoted the best cut-off for no FO. The sensitivity and specificity for the CS were 63% and 78% respectively. None of the factors evaluated for association with FO showed statistical significance on the multivariable logistic regression model.CONCLUSIONFO is very prevalent in patients on chronic HD at the Kenyatta National Hospital. CS detects FO less frequently when compared with BIA. The sensitivity and specificity for the CS were 63% and 78% respectively. None of the factors evaluated for association with FO showed statistical significance on the multivariable logistic regression model.

On some paleopathological examples of amputation and the implications for healthcare in 13th-17th century Lithuania

ObjectiveTo explore care that was likely provided to an adult male amputee from medieval Lithuania, positioning analysis within what is known of contemporary amputation practices. MaterialsThree sets of skeletal remains with evidence for amputation, dating to between the 13th-17th centuries AD and recovered during different archaeological excavations in Vilnius, Lithuania. MethodsMacroscopic inspection of lesions, with additional X-ray analysis of the main subject. The Index of Care was used to investigate possible caregiving. ResultsTwo individuals experienced amputation of a single element, and the third experienced bilateral hand amputation. Only one individual displayed healing. Historic sources suggest use of amputation for punitive purposes during this period, and judicial punishment is proposed as the most likely reason for amputation in at least two cases. ConclusionsEvidence of long-term healing in one individual suggests receipt of care. This individual likely relied on family and/or community members for survival immediately following amputation, and subsequently for support in managing disability. SignificanceSuccessfully combining osteology with history in a framework for analyzing care provision in past Eastern European society, this study underlines the critical importance of context in undertaking bioarchaeology of care analyses. It also adds two examples of perimortem abscissions in this region to the paleopathological record. LimitationsOur approach relied on skeletal interpretation. Soft tissue was lost to decomposition and no relevant archaeological evidence was found in association with the remains. Suggestions for further researchA review of skeletal collections may allow identification of overlooked cases of amputation (and care).

Analysis of patient outcome and owner satisfaction with double limb amputations: 14 dogs and four cats.

To evaluate the indications for, complications of, and surgical outcomes of dogs and cats that were treated with double limb amputations. 14 dogs and 4 cats that underwent double limb amputations. Data collected retrospectively included patient-specific (species, age, weight, breed, sex, existing comorbidities) and amputation-specific (indication for amputation, full or partial limb amputation, associated complications, need for revision surgeries) variables. Owner satisfaction scores were also collected. The most common indication for double amputations was trauma (12/18) patients. Eleven patients had both amputations performed simultaneously. Nine patients had double partial limb amputations versus full limb amputations. Twelve patients underwent bilateral pelvic limb amputations, 4 underwent bilateral thoracic limb amputations, and 2 had 1 pelvic and 1 contralateral thoracic limb amputated. Five patients had reported complications over the course of the follow-up period, and complications for 3 patients were considered major. Revision surgery was reported for 2 animals. Owner satisfaction scores were reported as very satisfied/excellent (14/18), mildly satisfied (3/18), and strongly dissatisfied (1/18). Median time to follow-up was 450 days (range, 85 to 4,380 days). Double limb amputation may be a viable alternative to advanced limb-sparing procedures or humane euthanasia based on the owner satisfaction data and the relatively low rate of major complications in this study. Future studies should clarify patient selection criteria and differences in function between surgical types.

Learning the Legs When You Have None

Living life in a wheelchair was never part of the plan, but life comes the way it comes. The speaker has endured a spinal surgery combined with a lower extremity amputation, proceeded through public schools, learning to play piano without the use of pedals, learning to drive, ultimately deciding a future in the medical field was the way to go. One of the biggest decisions that would face her would be deciding to not want a wheelchair to define her life. Which is why she always chose things that were considered for “able‐bodied” people. Throughout her education, there have always been classes that have been a bit of a struggle. However, one of the hardest was Gross Anatomy.This session will focus on the speaker’s lived experience as a bilateral lower extremity amputee navigating life and the health professional curriculum. For most people anatomy class is a little easier because they have all their limbs and can demonstrate on their own. But for her, not having those major parts, it was a bit of a struggle until her anatomy professor helped relate the lower extremity to the upper extremity. She can ambulate on her hands when not using her power wheelchair, so this technique helped to make that topic stick. This speaker will help demonstrate how anatomy educators can facilitate success for students with disabilities through an individualized approach.

Employment Status in Individuals with Upper-Limb Amputation: A Survey of Current Trends

ABSTRACT Introduction After upper-limb amputation, employment opportunities may be limited. Given the dramatic shift in the job market in the United States in the recent years, there is a need to examine the updated employment rates and the types of occupations to which individuals with amputation can return to. In this study, we assessed current employment status for people with upper-limb loss and determined whether these individuals needed to change jobs as a result of limb loss. Second, we examined whether demographic or impairment-specific factors were correlated with employment status or the need to switch jobs. Materials and methods Individuals with upper-limb amputation provided personal and employment information in an online survey. We explored the bivariate relationships between employment status and 11 personal factors (e.g., age at amputation, highest education level). Using the significant factors from this analysis, we built a logistic regression model for postamputation employment status. We also explored the relationship between these same 11 factors and the individuals' need to switch jobs after limb loss. Results A total of 199 and 160 respondents were deemed eligible for the employment status and job switch analyses, respectively. Of the working-aged respondents, 60.8% (121/199) were employed at the time of survey. Twenty-nine percent (47/160) reported needing to change jobs because of their amputation. Factors negatively associated with employment included having a bilateral amputation, lower education level, older age at amputation, higher pain frequency, and wearing a prosthesis less frequently. Higher education level was the only significant predictor of successful employment in the logistic regression model. There were no significant relationships between any factor and the need to change jobs after amputation. Conclusions The results suggest that individuals with upper-limb amputation have a lower employment rate than the national average. Future work should focus on understanding the reasons behind employment challenges in this population.

Enthesopathy, a Cause for Persistent Peristomal Pain after Treatment with an Osseointegrated Bone-Anchor: A Retrospective Case Series

ABSTRACT Introduction After limb loss, many patients undergo treatment with an osseointegrated implant. Unfortunately, some develop persistent peristomal pain after surgery. This can be sufficiently severe to reduce the speed of their rehabilitation or may halt the process altogether. The pain may be due to an enthesopathy of the residual muscles. We describe the phenomenon and outcomes of treatment in a series of patients who underwent treatment with an osseointegrated prosthetic limb, bone-anchor. Materials and Methods Over 36 months, we followed 14 patients with symptoms consistent with enthesopathy. Thirteen had undergone treatment with a transfemoral bone-anchor and one underwent treatment with a transhumeral bone-anchor. One patient had a bilateral transfemoral amputation. Analysis of the patients' ages, heights, weight at the time of surgery, length of residual femur, or preoperative dual-energy x-ray absorptiometry scans showed no correlation with the development of enthesopathy pain. Thirteen patients received steroid injections. Most received at least one injection of Adcortyl™ and bupivacaine. Patients were then encouraged to follow a program of physiotherapy to stretch out their enthesis, after injection. Results All patients experienced relief from their symptoms, but only two were rendered completely pain free. The remaining 11 patients gained sufficient control of their symptoms to allow them to continue daily use of their prosthesis with less difficulty or, where rehabilitation had been delayed or halted completely, to resume this process. Conclusion Enthesopathy seems to be a common phenomenon after bone-anchor surgery in individuals with transfemoral amputation. Steroid injections can help to relieve pain, allowing physiotherapy to be carried out. Patients undergoing treatment with a bone-anchor should be advised of the possibility of enthesopathy pain but can be reassured that there is a solution that works well in most cases. Clinical Relevance This article may be of benefit to clinicians who are struggling to manage patients with persistent peristomal pain after insertion of a bone-anchor. It may also encourage further research into measures for securing the soft tissues around the stoma for patients undergoing bone-anchor surgery.

VCA in the Era of the COVID-19 Pandemic.

VCA in the Era of the COVID-19 Pandemic.

786 Electrical Injury Resulting In Bilateral Upper Extremity Amputation: Improving Independence And Quality Of Life

IntroductionFifty seven year old male who sustained an electrical burn injury that resulted in bilateral below elbow amputation began inpatient rehabilitation program. Patient was motivated to increase independence to return home prior to prosthetic fitting and training being completed. Quality options for adaptive equipment required to increase independence were not sufficient to meet patients needs, thus innovative specialty fabrication of adaptive equipment were required to meet patient’s goals of independence.MethodsOccupational therapist to use thermoplastic material to fabricate various adaptive equipment in order to address patient's goals to increase independence with self care tasks. Occupational therapist and patient to have one time consult with hospital maintenance employee to create pant hook to use for ease of donning/doffing over hips. Patient participated in daily Occupational therapy sessions focused on trialing adaptive equipment and to provide feedback for any desired changes of equipment to maximize patient progress and success with reaching independence with self cares and return to life roles.ResultsPatient met all goals to become independent with self care tasks including: toileting, dressing and showering as a result of using fabricated adaptive equipment and techniques addressed during therapy sessions. Patient able to return home independently following discharge from inpatient rehabilitation stay.ConclusionsUse of easily accessible ezeform thermoplastic material can result in fabrication of adaptive equipment to increase patient's independence. It is important to maintain a creative outlook as a clinician and to continue to collaborate with our patient's to identify barriers to success and explore options to increase patient's desired independence.

Post-amputation pain among lower limb amputees in a tertiary care hospital in Jeddah, Saudi Arabia: A retrospective study.

Objectives:To estimate the prevalence of post- amputation pain among lower-limb amputees and its burden on their lives.Methods:A retrospective patients record review of lower limb amputation surgeries was carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between 2008-2019. e collected data included: patients demographics, surgical operations, chronic pain characteristics, functional impairment, and treatment.Results:A total of 645 lower-limb amputations carried out on 509 patients, 104 (20.4%) patients had more than one amputation surgery carried out, and 40 (7.9%) patients having bilateral amputations. The estimated prevalence of chronic post-amputation pain among the lower-limb amputees was approximately 61.5%. Persistent postoperative neuropathic pain was the most common type of pain following amputation, followed by residual limb pain, then phantom limb pain. The most common cause of amputation was diabetes and its related complications (76%). The mean age at surgery was 57.46±12.02 years. Although diabetes was a common comorbid illness (95.6%), it had no correlation with the development of chronic post-amputation pain. However, peripheral vascular disease had a strong association (p=0.009), especially with the development of phantom limb pain (54.5%; p=0.016). The most common reason for functional impairment among the amputees was disability (52.7%), while only 6.6% said it was secondary to pain.Conclusion:Post-amputation pain is one of the major consequences of amputation. Pain was poorly managed among these patients. Special considerations should be obtained to manage these patients’ pain and reduce their suffering.

Total Hip Replacement in a Patient with Bilateral Infrapatellar Amputation: Case Report, Literature Review, Tips and Tricks

Total Hip Replacement in a Patient with Bilateral Infrapatellar Amputation: Case Report, Literature Review, Tips and Tricks

Discrete Action Control for Prosthetic Digits.

We aim to develop a paradigm for simultaneous and independent control of multiple degrees of freedom (DOFs) for upper-limb prostheses. To that end, we introduce action control, a novel method to operate prosthetic digits with surface electromyography (EMG) based on multi-output, multi-class classification. At each time step, the decoder classifies movement intent for each controllable DOF into one of three categories: open, close, or stall (i.e., no movement). We implemented a real-time myoelectric control system using this method and evaluated it by running experiments with one unilateral and two bilateral amputees. Participants controlled a six-DOF bar interface on a computer display, with each DOF corresponding to a motor function available in multi-articulated prostheses. We show that action control can significantly and systematically outperform the state-of-the-art method of position control via multi-output regression in both task- and non-task-related measures. Using the action control paradigm, improvements in median task performance over regression-based control ranged from 20.14% to 62.32% for individual participants. Analysis of a post-experimental survey revealed that all participants rated action higher than position control in a series of qualitative questions and expressed an overall preference for the former. Action control has the potential to improve the dexterity of upper-limb prostheses. In comparison with regression-based systems, it only requires discrete instead of real-valued ground truth labels, typically collected with motion tracking systems. This feature makes the system both practical in a clinical setting and also suitable for bilateral amputation. This work is the first demonstration of myoelectric digit control in bilateral upper-limb amputees. Further investigation and pre-clinical evaluation are required to assess the translational potential of the method.

Adaptable Poly-Articulated Bionic Hands EnhanceBoth Performance and User's Perception in Bilateral Amputation: A Case Study.

This article evaluates and compares the performance and perception of prosthetic devices based on different design principles, a traditional rigid gripper and an adaptable poly-articulated hand, in a pre- and post-training protocol with an individual with bilateral amputation. As a representative of the first class, we use commercial hands (Ottobock's MyoHand VariPlus Speed), which is a widely adopted model by prosthesis users worldwide. We compare these with two SoftHand Pro hands, which are experimental prototypes exhibiting 19 articulations actuated by one single motor, and are inspired by human hand motor control models. Results show that the individual with bilateral amputation, who was a non-expert myoelectric user, achieved better performance with adaptive poly-articulated hands. Furthermore, the acceptation, satisfaction and perceived functionality of the user were considerably higher for the SoftHand Pro. An observational analysis of the patient's behaviour by experienced therapists suggests that adaptable poly-articulated hands reduced compensatory movements and cognitive load. Using soft technologies may be especially advantageous for individuals with bilateral amputation, who present a very limited residual mobility and can largely benefit from the active use of their artificial arms in everyday life.

Characteristics of Trunk Compensation Movements during Walking in People with Bilateral Transtibial Amputation: A Cross-sectional Study

ABSTRACTObjectives:The gait characteristics of people with bilateral transtibial amputation are not well understood. This study aimed to clarify changes in trunk lateral bending and the trunk flexion angle during walking in people with bilateral transtibial amputation.Methods:In this cross-sectional study, four participants with bilateral transtibial amputation who could walk without assistance (BTTA group) and ten able-bodied participants (control group) were recruited. The range of motion of trunk lateral bending, the trunk flexion angle, and other gait parameters during comfortable-speed and maximum-speed walking were measured using a three-dimensional motion analysis system and force plates. These parameters were compared between the amputees and the controls.Results:During maximum-speed walking, the BTTA group walked slower with a smaller trunk flexion angle (median, 1.75° vs. 4.79°, P=0.036) and greater double leg support time (0.18 vs. 0.12, P=0.008) when compared with the control group. The other parameters during maximum-speed walking were not significantly different between the two groups. During comfortable-speed walking, none of the parameters were significantly different between the two groups.Conclusions:Compensatory trunk flexion angle decreases markedly during maximum-speed walking in people with bilateral transtibial amputation. People with bilateral transtibial amputation may be changing the trunk flexion angle to walk faster. When evaluating gait compensation for people with bilateral transtibial amputation, trunk flexion angle may be an important index and maximum-speed walking is needed to detect the change in trunk flexion angle.

Sprinting with prosthetic versus biological legs: insight from experimental data.

Running-prostheses have enabled exceptional athletes with bilateral leg amputations to surpass Olympic 400 m athletics qualifying standards. Due to the world-class performances and relatively fast race finishes of these athletes, many people assume that running-prostheses provide users an unfair advantage over biologically legged competitors during long sprint races. These assumptions have led athletics governing bodies to prohibit the use of running-prostheses in sanctioned non-amputee (NA) competitions, such as at the Olympics. However, here we show that no athlete with bilateral leg amputations using running-prostheses, including the fastest such athlete, exhibits a single 400 m running performance metric that is better than those achieved by NA athletes. Specifically, the best experimentally measured maximum running velocity and sprint endurance profile of athletes with prosthetic legs are similar to, but not better than those of NA athletes. Further, the best experimentally measured initial race acceleration (from 0 to 20 m), maximum velocity around curves, and velocity at aerobic capacity of athletes with prosthetic legs were 40%, 1–3% and 19% slower compared to NA athletes, respectively. Therefore, based on these 400 m performance metrics, use of prosthetic legs during 400 m running races is not unequivocally advantageous compared to the use of biological legs.

Transcutaneous osseointegration for amputees with short residual bone: Is there increased risk for complications? – A pilot study

Aims: Transcutaneous osseointegration for amputees (TOFA) provides improved mobility and quality of life for most patients versus a traditional socket prosthesis. One uncertainty regarding TOFA is whether a minimum residual bone length is necessary to achieve solid fixation. This study evaluated the relationship between residual bone length and occurrence of post-TOFA complications requiring operative intervention. Patients and Methods: A retrospective review of our osseointegration registry was performed. Inclusion criterion was index osseointegration at least 12 months prior. Chart review included demographics and whether additional surgery occurred to manage noninfected loosening, periprosthetic fracture, and infection. Occurrence rates were compared using binary logistic regression analysis and by stratifying implants as <140 versus ≥140 mm. Results: Sixty segments were included (58 patients and 2 bilateral femur amputees). The implant length averaged 129.4 ± 31.1 (48–200) mm. No noninfected loosening occurred. Six patients (10%) had infection-related post-TOFA operation, at lengths ranging from 130 to 160 mm (representing the central 60% of implant lengths): five were debridement with implant retention and one other was removed. No implants below 130 mm (n = 19, 32%) required debridement or removal. Three patients (5%) had periprosthetic fracture (all femurs), at lengths ranging from 140 to 160 mm (the central 55% of implant lengths); no implants below 140 mm (n = 22, 37%) had periprosthetic fracture. Regression identified no association between length and noninfected loosening (P = 1.000), periprosthetic fracture (P = 0.999), or infection (P = 0.124). Dichotomized <140 versus ≥140 mm rates of complication were as follows: noninfected loosening (0/22 = 0% vs. 0/38 = 0%, P = 1.000), fracture (3/38 = 7.9% vs. 0/22 = 0%, P = 0.292), and infection (5/38 = 13.2% vs. 1/22 = 4.5%, P = 0.400). Conclusion: Residual bone length does not appear to be associated with post-TOFA reoperation to address noninfected loosening, periprosthetic fracture, or infection. The "minimum necessary" length of bone to achieve stable transcutaneous osseointegration capable of supporting full body weight remains uncertain.

REHABILITATION AND SOCIAL COUNSELING FOR PEOPLE WITH BILATERAL LOWER LIMB AMPUTATION

The purpose: bilateral amputation of the lower limbs is a significant intervention in a person's life. It affects him physically as well as socially. Having changed living conditions, our task is to resocialize the individual.Materials and methods. In our study, we explored the case of NRC Kováčová, diagnosed with bilateral amputation of the lower limbs. Between the beginning of 2017 and the end of 2021, they underwent an eight-week rehabilitation program. Retrospective data collection and analysis were conducted. Results: As a result of complex treatment, patients are able to become more self-sufficient in normal daily activities. Reintegration is encouraged by improving self-sufficiency, to which social counseling also contributes.Conclusions. We confirm the positive effects of social counseling and rehabilitation after bilateral amputation of the lower limbs in our paper. In addition, participating in group rehabilitation supports the socialization and reintegration of the individual, resulting in an improvement in quality of life for them.

A Comparison of the Two-Minute Walk Test (2MWT) and Comprehensive High-level Activity Mobility Predictor (CHAMP) in People with a Leg Prosthesis

Objective To determine if the two-minute walk test (2MWT) could serve as an alternative measure of high-level mobility in lower limb prosthesis users when circumstances preclude administration of the Comprehensive High-level Activity Mobility Predictor (CHAMP). Design Cross-sectional study. Setting Indoor recreational athletic field and gymnasium Subjects Fifty-eight adult lower limb prosthesis users with unilateral or bilateral lower limb amputation who participate in recreational athletic activities. Intervention N/A Main Measures The 2MWT and CHAMP while using their preferred prosthesis(es) on an indoor artificial athletic field or hardwood gymnasium floor. Results Thirty-nine men and nineteen women with a median age of 38.3 years participated in the study. Most participants experienced amputation(s) due to trauma (62%) or tumor (10%) and were generally higher functioning (K4 (91.4%) and K3 (8.6%)). The median (range) score for the CHAMP was 23.0 points (1.5–33.5) and the mean ± standard deviation (range) 2MWT distance walked was 188.6 ± 33.9 m (100.2–254.3 m). The CHAMP demonstrated a strong positive relationship with 2MWT (r = 0.83, p < 0.001). The 2MWT distance predicted 70% of the variance in CHAMP score. Conclusions Although the 2MWT does not test multi-directional agility like the CHAMP, they were found to be highly correlated. If space is limited, the two-minute walk test can serve as an alternative measure for assessing high-level mobility capabilities in lower limb prosthesis users.