Date of Award

5-2021

Document Type

Thesis

Keywords

Consecutive lower extremity amputations, revascularization procedure, physical therapy rehabilitation post-amputation, acute care management.

Abstract

Background and Purpose. This case report describes the acute care management of an 85-year-old male with three consecutive lower extremity amputations and one associated revascularization procedure at attempt of limb salvage. The purpose of this report is to describe the effects of chronic conditions on various body systems and how they relate to physical therapy rehabilitation post-amputation since limited research is present in this area of physical therapy practice.

Case Description. The patient had a very extensive and complicated medical history which included type Il diabetes mellites, chronic kidney disease and peripheral artery disease. His primary goal was to return home to his wife; however, the sequence of three amputations and respective hospitalizations had negatively affected his physical and emotional status. This resulted in the patient's discharge to a subacute rehabilitation setting after all three amputations and respective acute care hospitalizations.

Intervention. Interventions of transfer training, bed mobility, assistive device/gait training, patient education, strengthening, activity pacing, energy conservation and neuroreeducation were all included at some point in the patients' plan of care.

Outcomes. Throughout the patients' acute care hospitalization with physical therapy intervention, the patient displayed a steady progression of increased pain, decreased strength, decreased endurance, decreased ability to independently perform activities of daily living and decreased ability to perform self-care tasks.

Discussion. The prognosis following each subsequent amputation and respective hospitalization had declined drastically. Although acute physical therapy helped the patient improve physically post-amputation , the prognosis for the patient was still less than optimal moving forward.

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