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Analysis of selected factors determining quality of life in patients after lower limb amputation- a review article

100%
Grzebień A., Chabowski M., Malinowski M., Uchmanowicz I., Milan M., Janczak D.
Polish Journal of Surgery
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2017
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vol. 89(2)
57-61
EN
The amputation of the lower limb is a crippling procedure, which impairs both physical and mental aspect of the patient’s life and therefore, it is important to provide these patients with comprehensive health care. Patients and their families must change their lives and reorganize them, which is undoubtedly associated with a decrease in the quality of life. The aim of this study was to analyze various determinants of quality of life in patients after lower limb amputation and their impact on the physical, mental and social aspect of life. Based on the available literature, this paper discusses certain factors determining quality of life, including the presence of phantom pain and stump pain, the way patients move, independence in daily activity, occupational activity, and access to rehabilitation. Analysis of the impact of particular factors on quality of life in people after lower limb amputation may contribute to the improvement and introduction of new paradigms regarding care provided for amputees.
2
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The characteristics of Indonesian para-cycling athletes’ injuries

100%
Hanief Y. N., Umar F.
Advances in Rehabilitation
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2020
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vol. 34
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issue 3
37-46
EN
Introduction Amputee cyclists with different types of disabilities compete in same category in the Paralympics Games, and para-cycling has the highest risk of injury. This is because the areas used for training are velodromes and highways. The nature of these injuries is closely related to the recovery rate, absence from training, and even the end of a career. This study aimed to determine the characteristics of sports injuries sustained by para-cycling athletes when joining the Indonesia National team.

 Material and methods The sample was a group of 19 athletes (16 males and three females) with a mean age of 30 ± 5.02. A questionnaire consisting of 25 questions was used to obtain data, which was adapted from Nowak’s questionnaire. Data analysis was represented in the form of numbers and percentages, and Fisher's exact test was used to determine the relationship between variables.

 Results The results showed injuries are most common in the lower limbs (57%) by falling (73%). The effects of the athletes’ falls are bruises (42%), twists or sprains (17%), and fractures (17%).

 Conclusions Para-cycling athletes experience the lower extremity injuries. An athletes' fall affects the lower extremities leading to contusion or bruises (on the knee and lower leg, when falling during training), twist or sprain (in the ankle, occurs during a training session), and fracture (caused by a fall during a training session).
3
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The Effects of Rearfoot Position on Lower Limb Kinematics during Bilateral Squatting in Asymptomatic Individuals with a Pronated Foot Type

88%
Power V., Clifford A.
Journal of Human Kinetics
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2012
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vol. 31
5-15
EN
Clinicians frequently assess movement performance during a bilateral squat to observe the biomechanical effects of foot orthotic prescription. However, the effects of rearfoot position on bilateral squat kinematics have not been established objectively to date. This study aims to investigate these effects in a population of healthy adults with a pronated foot type.Ten healthy participants with a pronated foot type bilaterally (defined as a navicular drop >9mm) performed three squats in each of three conditions: barefoot, standing on 10mm shoe pitch platforms and standing on the platforms with foam wedges supporting the rearfoot in subtalar neutral. Kinematic data was recorded using a 3D motion analysis system. Between-conditions changes in peak joint angles attained were analysed.Peak ankle dorsiflexion (p=0.0005) and hip abduction (p=0.024) were significantly reduced, while peak knee varus (p=0.028) and flexion (p=0.0005) were significantly increased during squatting in the subtalar neutral position compared to barefoot. Peak subtalar pronation decreased by 5.33° (SD 4.52°) when squatting on the platforms compared to barefoot (p=0.006), but no additional significant effects were noted in subtalar neutral.Significant changes in lower limb kinematics may be observed during bilateral squatting when rearfoot alignment is altered. Shoe pitch alone may significantly reduce peak pronation during squatting in this population, but additional reductions were not observed in the subtalar neutral position. Further research investigating the effects of footwear and the subtalar neutral position in populations with lower limb pathology is required.
4
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Influence of anxiety on the muscles strength in the leg after ACL reconstruction

51%
Dubaj W., Jarosz A., Hładki W.
Medical Rehabilitation
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2012
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vol. 16(4)
13-20
PL
Założenia: Izolowane zerwanie więzadła krzyżowego przedniego kolana ACL jest trzecim co do częstości urazem więzadłowym stawu kolanowego. Postępowanie obejmuje rekonstrukcję i rehabilitację pooperacyjną. Wyniki leczenia ocenia się m.in. na podstawie testów ortopedycznych, badań siły mięśniowej i pomiarów obwodów, porównywanych do nogi przeciwnej. Stan kliniczny operowanego więzadła nie zawsze jest zbieżny z odczuciami pacjenta co do własnego zdrowia. Wpływ na samoocenę zdrowia przez pacjenta i przebieg rehabilitacji ma między innymi nasilenie lęku. Cel: Ocena wpływu predyspozycji do reagowania lękiem na skuteczność rehabilitacji, ocenianej w oparciu o pomiary siły mięśni, po operacyjnym leczeniu przerwanego więzadła krzyżowego przedniego kolana. Materiał i metoda: Badano 201 pacjentów z rozpoznanym zerwaniem więzadła krzyżowego przedniego kolana (113 kobiet i 88 mężczyzn). Wszyscy pacjenci zostali poddani rekonstrukcji więzadła krzyżowego przedniego oraz sześciomiesięcznemu leczeniu rehabilitacyjnemu. Do oceny nasilenia lęku jako cechy badanego przed zabiegiem operacyjnym zastosowano Kwestionariusz STAI, a do dwukrotnego badania siły mięśni (tydzień przed i po 6 miesiącach od operacji) zastosowano dynamometr.Wyniki: Badani wykazujący małe nasilenie lęku-cechy (poniżej 3,5 stena) istotnie częściej niż badani wykazujący duże nasilenie lęku-cechy (powyżej 7,5 stena) uzyskiwali po rehabilitacji zwiększenie siły mięśni przywodzicieli stawu biodrowego i prostowników stawu kolanowego, oraz poprawę w teście leg press operowanej kończyny dolnej.Wnioski: Zwiększona predyspozycja do reagowania lękiem może być przyczyną gorszych wyników rehabilitacji pacjentów po operacyjnej rekonstrukcji więzadła krzyżowego przedniego. W przypadku pacjentów o nasilonym lęku, rehabilitowanych po operacyjnej rekonstrukcji więzadła krzyżowego przedniego, należy rozważyć zastosowanie indywidualnego programu rehabilitacji, uwzględniającego psychoterapię.
EN
Background: The rupture of the anterior cruciate ligament (ACL) constitutes the third most frequent ligament injury of the knee joint. The approach involves its reconstruction and post-operational rehabilitation. The results of treatment are evaluated on the basis of, among other things, orthopaedic tests, tests of muscle strength and circumference measurements when compared to the other leg. The clinical state of the ligament is not always in accordance with the patient’s perceptions as to their state of health. An influence on the self evaluation of health on the part of the patient is brought about by, among other things, an intensification in fear and anxiety.Objective: An evaluation of the influence of a predisposition for an anxiety reaction on the effectiveness of rehabilitation, evaluated in relation to the measurement of muscle strength, following operational treatment of the injured ACL.Materials and Methods: 201 patients (113 women and 88 men) were tested who had a diagnosed of the ACL injury. All the patients were subjected to a reconstruction of the ACL as well as a period of six months of rehabilitation treatment. The STAI questionnaire was used in the evaluation of the trait-anxiety prior to the operational procedure, while twice a dynamometer was used in the testing of muscle strength (a week before and six months after the operation).Results: Those patients displaying a small intensification in trait-anxiety (lower than 3.5) significantly more often than those patients displaying a large intensification in trait-anxiety (over 7.5) gained increased muscle strength following rehabilitation of the hip joint adductor and the extensors of the knee joint, as well as an improvement in the leg press test of the lower limb operated on. Conclusions: An increased predisposition for an anxiety reaction may be the reason for poorer rehabilitation results in patients following an operational reconstruction of the ACL. It may be necessary in the case of patients undergoing rehabilitation after an operational reconstruction of the ACL and who display an intensive anxiety of the said to consider the application of an individual programme of rehabilitation, one incorporating elements of psychotherapy.
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