[Amputation and prosthesis attachment of the lower extremities]

Patient satisfaction after lower limb replantation surgery for traumatic amputation - a qualitative study

BACKGROUND

The majority of published literature clinically assesses surgical outcomes after lower limb replantation for traumatic amputations. However, patients' satisfaction and quality of life may not be accurately measured through rigid scoring using standardized patient reported outcome measures.

PURPOSE

The aim of this study was to qualitatively assess patient satisfaction and factors associated with achieving good outcomes after successful lower limb replantation surgery.

METHODS

A semi-structured interview was conducted with 12 patients who underwent lower limb replantation surgery following traumatic amputation injuries. The interview focused on the patients' experience and satisfaction throughout their injury, surgical journey, rehabilitation and reintegration into their communities. An inductive and deductive thematic analysis was applied using the recorded transcripts to evaluate the overall satisfaction of the patients after lower limb replantation surgery.

RESULTS

The following observations emerged from the structured themes among all the patients interviewed: (1) Family and social support was significantly associated with improved qualities of life and satisfaction after lower limb replantation; (2) Patients were generally satisfied with their outcomes despite limitations in physical capabilities; (3) Satisfaction was associated with acceptance of their cosmetic deformity; (4) Social integration and being able to participate in a meaningful manner was associated with greater satisfaction after recovery.

CONCLUSIONS

Patients who undergo lower limb replantation can have a significantly improved quality of life if they have strong social support, are able to contribute in a meaningful manner to their communities after surgery, and are accepting of their cosmetic deficiencies.

[Gait Training for Lower Limb Amputees - A Systematic Review Based on the Research Pyramid]

BACKGROUND

Lower extremity amputation patients have gait asymmetries which can lead to further complaints in other joints of the body.

METHOD

Five relevant databases were systematically searched for studies about gait training methods among people with transtibial and transfemoral amputations, followed by an evaluation of the methodical power of the eight references. Subsequently, the studies were categorized into the evidence classes of the research pyramid. The aim was to give treatment recommendations for this patient group.

RESULTS

All training methods show an improvement in gait parameters of the patients. In seven studies at least four different training forms are used within one training intervention. Therefore, a combination of different forms seems promising. A long-term statement among these methods could not be made. Due to the high variability in intervention methods and outcome parameters, an aggregation of data and meta-analyses were not possible.

CONCLUSION

The Evidence-Based Amputee Rehabilitation Program provides a good basis for a standardized training method. It should be supplemented with functional dual-task training and education. In further research a specific duration and intensity of such a program needs to be investigated. On top of that further qualitative and observational research is needed to generate statements which optimize the gait training in the physiotherapeutic routine practice.

Die Übersetzung und kulturelle Adaptation des Locomotor Capabilities Index-5 (LCI-5) ins Deutsche

Hintergrund In Deutschland existiert bisher keine deutsche, validierte Version eines patientenbezogenen Messinstruments, das bei Personen mit Amputation der unteren Extremität spezifisch die Funktionsfähigkeit mit Prothese im Alltag erfasst. Der Locomotor Capabilities Index-5 (LCI-5) ist ein international verwendetes Messinstrument zur Erhebung dieses Konstruktes.

Ziel Die leitlinienkonforme Übersetzung und kulturelle Adaptation des Locomotor Capabilities Index-5 (LCI-5) in die deutsche Sprache.

Methode Der LCI-5 wurde anhand der ISPOR-Leitlinie zur Übersetzung und kulturellen Adaptation von patientenzentrierten Messinstrumenten in die Zielsprache Deutsch übersetzt. In diesem Kontext wurden zunächst zwei unabhängige Vorwärtsübersetzungen in die Zielsprache erstellt und verglichen. Es folgten zwei unabhängige Rückwärtsübersetzungen dieser Synthese durch Muttersprachler der Originalsprache (Englisch) mit einem anschließenden Review. Der daraus resultierende Fragebogen wurde in einer Pilottestung (N = 8) auf Sprach- und Verständnisprobleme sowie kulturelle Stimmigkeit überprüft und angepasst.

Ergebnisse Der LCI-5 wurde in die deutsche Version namens Locomotor-Capabilities-Index-5-D (LCI-5-D) übersetzt und kulturell adaptiert. Die Überprüfung des Fragebogens in der Pilottestung führte zu zwei Wortabänderungen.

Schlussfolgerung Eine autorisierte Version des LCI-5 konnte in die deutsche Sprache übersetzt werden (LCI-5-D). Die Gütekriterien dieser deutschen Version werden in einer darauf aufbauenden Validationsstudie untersucht.