Article

In patients with a transfemoral amputation socket-related problems
are associated with reduced prosthetic use, activity, and quality of life.
Furthermore, gait asymmetries are present that may explain secondary complaints.
Bone-anchored prostheses (BAPs) may help these patients. Two types of BAP are
available, screw and press-fit implants. Rehabilitation following surgery for a
press-fit BAP is poorly described. PURPOSE: To describe a rehabilitation program
designed to minimize compensation strategies and increase activity using a
case-report of an active, 70-year-old man with a traumatic transfemoral
amputation who had used a socket prosthesis for 52 years and received a press-fit
BAP [Endo-Exo Femoral Prosthesis - EEFP]. INTERVENTION: A 13-week physiotherapy
program. OUTCOMES: Outcomes were assessed before surgery, at the end of
rehabilitation, and six-month and one-year follow-ups. After rehabilitation gait
had improved, the patient had more arm movement, more pelvic shift, less hip
rotation during swing phase on the prosthetic side, and absence of vaulting on
the sound side. Isometric hip abductor strength was 15% higher on the sound side
and 16% higher on the prosthetic side, and walking distance increased from 200 m
to 1500 m. At the six-month follow-up, the patient had lower back complications
and reduced hip abductor strength and walking distance. At one-year follow-up,
walking distance had recovered to 1000 m and gait pattern had improved again,
with yielding and absence of terminal impact on the prosthetic side. CONCLUSION:
The described rehabilitation program may be an effective method of improving gait
in patients with an EEFP even after long-term socket usage.

Langue : ANGLAIS