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General community rehabiliation group and amputee management - Coggle…
General community rehabiliation group and amputee management
OVERVIEW
once/week general rehabiliation group offered, inclusive for post amputees
group is circuit based including warm up, strenghtening upper limb and lower limb, CV workout and stretching
Is this meeting the needs of clients post amputation?
rural generalist sole practitioner
FACTS
first point of contact for community based physio is once the client is discharged home, using community based CHSP funded service for over 65years
high incidence of DM in our community
high incidence of CV disease in our community
demographics line up with male, over 45 years highest incidence of vascular amputations
amputation clinic offered at Latrobe Hospital (LRH), 2 hours away
prosthetic provider also 2 hours drive away
Team available at location is OT, Social worker, dietician, diabetes educator, chronic disease nurse, district nurse, GP clinic, physiotherapist, psychologist, home car package providers, podiatrist and Allied health assistants.
post rehabilitation in larger hospital, patient would get discharged home or transferred to our local hospital for Discharge planning. Hopefully referring to outpatient physiotherapy
Pre-op physio role limited but could work together with physio from LRH if driving was an issue.
Exercise group has initial assessment including history, pre-morbid mobility levels.PMHx, SHx, objective measures and goal setting. Exit assessment offered at end of program
BENEFITS
improved education of client leads to early detection of issues such as skin break down, ill fitting prosthetic or changes to the stump.
early detection means earlier intervention, leading to improved outcomes for the client
improved education of the physiotherapist leads to increased checking of skin and stump before and after and during treatment.
involve district nurses or podiatrist early on to avoid bigger problems
knowing who to call when in doubt, will mean quicker follow up of issues
improved community care can lead to less hospitalisations
rehabilitation group will strenghten upper and lower limb muscles using open and closed chain exercises. It will strenghten core stability and improve cardio vascular fitness. It also provides a social outing and boosts morale.
FEELINGS
glad to have had this opportunity to learn more about amputee managment
with this increased knowledge, can offer more education to patient and stress the importance of skin management
a little disappointed to not have given the best care to client post amputation earlier last year
if problem arises, I know first point of call so I don
t feel like I
m in it all alone
DIFFICULTIES
not adressing foot wear or emotional status during initial assessment
stump observation is not done due to lack of knowledge
limited education would be provided due to lack of knowledge
limited knowledge on different types of prosthetics, sockets, interface and suspension mechanism
only one client with amputation in community rehabiliation group in 5 years. Cause ? older, less able demographic
rehabiliation group is not specifically aimed at gait retraining or balance
POSSIBILITIES
slot in extra one on one physiotherapy sessions on top of the rehabilitation class to allow time for checking of skin, issues or gait analysis
liaise closer with podiatrist for these at risk clients to identify problems early
refer to dietician or diabetes educator if not done so already
opportunity to visit LRH and watch prosthesist and rehabiliation group up close. this would provide opportunity to learn as well as making connections