Ingenuity of ADL and prosthetic gait for patient with bilateral above-knee amputation, right hemiplegia and higher brain dysfunction

Abstract

We experienced a case of a mature male patient with bilateral above-knee amputation, right hemiplegia, and higher brain dysfunction, and reported that he became independent in his activities of daily living except for bathing and was able to walk with prosthetic legs with assistance. We selected a tilt-recline electric wheelchair that can be operated by the non-paralyzed hand and can accommodate the limited range of motion of the hip joint, backward transfer in the direction of the paralyzed side, and placement of the changing table behind the portable toilet. As a result, the patient was able to move and transfer, expand his range of living, and become independent in defecation. The bilateral femoral prostheses were suspended in quadrilateral sockets, silicone liners and Velcro, with fixed knees and carbon feet. While the patient’s dignity was enhanced by conducting ADL training and gait training in parallel, frequent guidance to family members was important for improving physical and mental functions, ADL, and walking ability.