The Japanese Journal of Rehabilitation Medicine
Online ISSN : 1881-8560
Print ISSN : 1881-3526
ISSN-L : 1881-3526
チームアプローチにより義足での日常生活動作獲得に至った大腿切断合併関節リウマチの1例
田畑 阿美中谷 未来入江 雄二伊藤 宣南角 学山脇 理恵池口 良輔松田 秀一
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論文ID: 20015

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A 70-year-old woman with rheumatoid arthritis underwent above-knee amputation due to osteomyelitis after right total knee arthroplasty. After the surgery, the patient started rehabilitation for wearing a prosthetic leg. However, the patient could not wear the prosthesis by herself because of severe upper limb impairment due to bilateral finger joint deformity and muscle weakness associated with the rheumatoid arthritis. Therefore, physical therapists and prosthetists/orthotists collaborated to determine movements that could be performed, even with muscle weakness, using assistive devices such as a Velcro strip handle with the prosthesis and a prosthetic liner stand. Subsequently, repetitive training was performed in an environment similar to the setting of the patient's prosthesis use at home. Consequently, although no change in upper limb function was observed, the patient had increased independence during prosthesis attachment. As she had difficulty wearing and removing her trousers/underwear while wearing the prosthesis, she performed movements using assistive devices and made changes to the order of movements. Six months after the surgery, she could wear the prosthesis and perform self-care correctly by herself and return home. Therefore, to maximize function that enables independence after amputation, helping patients learn how to put on the prosthesis using a team approach is important.

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