Het ondergaan van een eenzijdige beenamputatie is een drastische chirurgische ingreep. Mensen, die na een amputatie in staat zijn om te lopen met een prothese, zijn functioneel onafhankelijker, en hebben een hogere kwaliteit van leven dan mensen die in een rolstoel belanden. Het is daarom niet verrassend dat het herwinnen van de oopvaardigheid één van de voornaamste doelen is tijdens de revalidatie. Doel van het onderzoek was om inzicht te krijgen in de factoren die het herwinnen en onderhouden van de loopvaardigheid van mensen na een beenamputatie beïnvloeden. Gebaseerd op de resultaten van het onderzoek kan geconcludeerd worden dat de fysieke capaciteit hierbij een belangrijke rol speelt. Een relatief kleine verbetering in de capaciteit kan al resulteren in significante en klinisch relevante verbeteringen. Hoewel geavanceerde prothesen de mechanische belasting van het lopen met een beenprothese verminderen, kan een ineffectieve balanscontrole deze positieve resultaten weer tenietdoen. ABSTRACT Undergoing a lower limb amputation is a life-changing surgery. The ability to walk greatly influences the subject's functional independence and quality of life. Not surprisingly, regaining walking ability is one of the primary goals during prosthetic rehabilitation. The primary aim of the research performed was to enhance our understanding of some of the factors that influence the ability to regain and maintain walking after a unilateral lower limb amputation. Based on the results we can deduce that a person's physical capacity plays an important role in their walking ability. Relatively small improvements in capacity could lead to significant and clinically relevant improvements in people's walking ability. Furthermore, results show that sophisticated prosthetic feet can reduce the mechanical load experienced when walking with a prosthesis. Interestingly, inefficient balance control strategies can undo any positive effect of these prostheses.
Objective This study aims to identify determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation, from the perspectives of both wheelchair users and rehabilitation professionals. The findings should contribute to the field of health promotion programs for wheelchair users. Methods Five focus groups were held with wheelchair users (n = 25), and two with rehabilitation professionals (n = 11). A thematic approach was used for data analysis in which the determinants were categorized using an integrated International Classification of Functioning, Disability and Health and Attitude, Social influence and self-Efficacy model. Results Reported personal factors influencing dietary behaviour in wheelchair users were knowledge, boredom, fatigue, stage of life, habits, appetite, self-control, multiple lifestyle problems, intrinsic motivation, goal setting, monitoring, risk perception, positive experiences, suffering, action planning, health condition, function impairments, attitude and self-efficacy. Reported environmental factors influencing dietary behaviour in wheelchair users were unadjusted kitchens, monitoring difficulties, eating out, costs, unfavourable food supply, nutrition education/counselling, access to simple healthy recipes, eating together, cooking for others, and awareness and support of family and friends. Conclusions Important modifiable determinants of dietary behaviour in wheelchair users that might be influenced in lifestyle interventions are knowledge, fatigue, habits, self-control, intrinsic motivation, risk perception, attitude and self-efficacy. It is recommended to involve relatives, since they appear to significantly influence dietary behaviour.
PURPOSE: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amputees of 500 m or more.METHOD: A total of 437 patients returned two questionnaires: the Groningen Questionnaire Problems after Leg Amputation, in which walking distance was assessed, and the RAND 36.RESULTS: The chance of walking 500 m or more reduced when a transfemoral amputation was performed. The chance reduced even more when phantom pain or stump pains were present. If the amputation was performed because of vascular disease or because of vascular problems because of diabetes the chance reduced again. Independently of these factors, age reduced the chance of walking 500 m or more.CONCLUSION: The chance of walking 500 m or more reduces with increase in age and a more proximal amputation. The chance reduces even further when the amputation is performed because of diabetes or vascular disease and also if phantom pain and or stump pain is present.
