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Background and Purpose: With 1.6 million Americans living with limb loss, transtibial amputations (TTA) are the most common type of below the knee amputations, and may contribute to concomitant musculoskeletal impairments, gait deviations, and decreased community ambulation. The purpose of this report was to describe the use of specific functional outcome measures, gait training with a prosthetic, and physical therapy (PT) intervention for functional mobility of a patient following a TTA. Case Description: The patient was a 68-year old female referred to outpatient PT 3 months following a right TTA. She presented with left lower leg pain and inability to ambulate with a prosthetic. Her initial evaluation demonstrated decreased lower extremity strength, range of motion (ROM), and impaired balance. The patient received 12 weeks of PT, combining manual therapy, therapeutic exercise, and gait training to decrease pain and improve functional mobility. Outcomes: Following 7 weeks of treatment, the patient demonstrated increased bilateral lower extremity strength in hip extension (R/L: 3-/5 - 4/5) and abduction (R: 4/5 - 5/5, L: 4-/5 - 4+/5) with improved performance of strength and balance exercise. Her right knee flexion ROM increased (114-120 degrees) and she was able to progress from parallel bars to lofstrand crutches and increase walking distance (5ft to 50ft). She completed two trials of the L-test using lofstrand crutches (1.22sec, 1.31sec). Discussion: This case report suggests that appropriate outcome measures combined with PT intervention of strength and gait training may be beneficial in rehabilitation of a patient following TTA. Further research should be done on the effects of continued prosthetic adjustments and associated knee OA of intact limb on long term ambulation outcomes.
© 2020 Kellie Guillies
Guillies, Kellie, "Assessment Of Performance Measures, Gait, And Rehabilitation Of A 68- Year Old Female With A Transtibial Amputation: A Case Report" (2020). Case Report Presentations. 13.