Below-knee (BK) amputation is one of the most commonly performed actions in dysvascular cases, but rare caused by arterial stenosis. Those had significant impacts on clinical functions and affect the contralateral limb, so its need adequate supervision during rehabilitation programs. The report are to describe the stump wound healing of the patient after amputation surgery, stump preparation at pre-prosthetic phase, prevention of knee contracture, prosthetic preparation and use, gait training and evaluation of unaffected limb. A 44-years old female with right below-knee amputation caused by stenosis of right peroneal and dorsalis pedis artery, and the wound in the residual limb was not healed within 4 weeks. She got rehabilitation to accelerate stump healing and stump shaping, maintain knee flexibility, muscle strengthening, cardiovascular endurance, transfer and ambulation. She had good compliance to the programs and achieved independent ambulation using the prosthetic within 6 months. Improvement in residual limb healing within 6 weeks, pain reduction from VAS score 3 to zero, and stump shape changes from buldging to conical. And also in knee joint range of motion, transfer ability, gait pattern using BK prosthetic (by modifying shoe components), and the patient's ability to carry out ADL (BI score 75 to 100). Laser therapy, stump shaping, flexibility exercise, strengthening exercise, endurance exercise, ambulation exercise and prosthetic use on transtibial dysvascular amputation showed good results for ADL. Careful examination to the unaffected limb could identify early occurence of stenosis. Early intervention could prevent future ischaemia and amputation.
Imanawanto, K., & Utami, D. A. (2022). Dysvascular Transtibial Amputation Due To Artery Stenosis: A Case Report Study. Surabaya Physical Medicine and Rehabilitation Journal, 4(1), 37–43. https://doi.org/10.20473/spmrj.v4i1.22755
Uustal H, Baerga E. Physical Medicine and Rehabilitation Broad Review. In: Amputation and Prosthetics. 3rd ed. New York: Demos Medical Publishing; 2015. p. 477.
Fard B, Dijkstra PU, Stewart RE, Geertzen JHB. Incidence rates of dysvascular lower extremity amputation changes in Northern Netherlands: A comparison of three cohorts of 1991-1992, 2003-2004 and 2012-2013. PLoS One. 2018;13(9):2003–4.
Lovegreen W, Murphy DP, Stevens PM, Seo Y IL, Webster JB. Lower Limb Amputation and Gait. Braddom’s Physical Medicine and Rehabilitation. Philadelphia: Saunders Elsevier; 2016. 174–208 p.
Turner S, McGregor AH. Perceived Effect of Socket Fit on Major Lower Limb Prosthetic Rehabilitation: A Clinician and Amputee Perspective. Arch Rehabil Res Clin Transl. 2020;2(3):100059.
Webster JB. Lower Limb Amputation Care Across the Active Duty Military and Veteran Populations. Phys Med Rehabil Clin N Am. 2019;30(1):89–109.
Zhao H, Hu J, Zhao L. The effect of low-level laser therapy as an adjunct to periodontal surgery in the management of postoperative pain and wound healing: a systematic review and meta-analysis. Lasers Med Sci. 2021;36(1):175–87.
Mosca RC, Ong AA, Albasha O, Bass K AP. Photobiomodulation Therapy for Wound Care: A Potent, Noninvasive, Photoceutical Approach C L I N I C A L M A N A G E M E N T extra. Adv Ski Wound Care. 2019;32(4) (April 2019):157–67.
Koonalinthip N, Sukthongsa A, Janchai S. Comparison of Removable Rigid Dressing and Elastic Bandage for Residual Limb Maturation in Transtibial Amputees: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2020;101(10):1683–8.
O’Banion LA, Dirks R, Farooqui E, Kaups K, Qumsiyeh Y, Rome C, et al. Outcomes of major lower extremity amputations n dysvascular patients: Room for improvement. Am J Surg. 2020;220(6):1506–10.
Jeffers JR, Grabowski AM. Individual leg and joint work during sloped walking for people with a transtibial amputation using passive and powered prostheses. Front Robot AI. 2017;4(DEC):1–10.
Ghazali MF, Razak NAA, Osman NAA, Gholizadeh H. Awareness, potential factors, and post-amputation care of stump flexion contractures among transtibial amputees. Turkish J Phys Med Rehabil. 2018;64(3):268–76.
Christiansen CL, Miller MJ, Murray AM, Stephenson RO, Stevens-Lapsley JE, Hiatt WR, et al. Behavior-change intervention targeting physical function, walking, and disability after dysvascular amputation: a randomized controlled pilot trial. Arch Phys Med Rehabil. 2018;99(11):2160–7.
Crozara LF, Marques NR, LaRoche DP, Pereira AJ, Silva FCC, Flores RC, et al. Hip extension power and abduction power asymmetry as independent predictors of walking speed in individuals with unilateral lower-limb amputation. Gait Posture. 2019;70:383–8.
McDonald CL, Kramer PA, Morgan SJ, Halsne EG, Cheever SM, Hafner BJ. Energy expenditure in people with transtibial amputation walking with crossover and energy storing prosthetic feet: A randomized within-subject study. Gait Posture. 2018;62:349–54.
Selvam PS, Sandhiya M, Chandrasekaran K, Rubella DH, Karthikeyan S. Prosthetics for Lower Limb Amputation. In: Prosthetics and Orthotics. IntechOpen; 2021.
Mohanty RK, Kumar JP, Rout S, Das SP. Successful prosthetic rehabilitation and gait analysis of individual with bilateral transtibial amputation: A case study with comparison to able-bodied gait. J Orthop Trauma Rehabil. 2020;27(1):93–100.
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