Introduction: The rehabilitation of bilateral lower limb amputees is generally more intensive than that of unilateral amputees and poses a great challenge to both there habilitation team and the amputees themselves. Bilateral amputees who are fitted with standard full length prostheses find it difficult to walk fast or climb up and down stairs. Usually stubbies, or short prostheses with non-articulated rocker bottoms, are also provided. Stubbies enables the amputee to use Indian type toilets with the help of a low level folding portable commode; in addition, it helps the amputee to work outdoors in gardens and fields. Stubbies particularly suitable for bilateral amputees in developing countries like India. Objective: To find out the effect of stubbies with gait training in bilateral transfemoral amputee as well as to measure Metabolic cost index during walking and stair climbing in bilateral trans-femoral amputee using stubbies. Design: Post test control group design. Participants: Subjects with bilateral transfemoral amputation (N=10; 8 men, 2women; age, 36.5±5.64 years; range, 25 –45 years) and able bodied subjects(N=10 ; 8men , 2 women; age, 34.5±5.99 years; range,25-45 years) . Intervention: Research participants were fitted with stubbies at NIOH, Kolkata and after the fitment of prosthesis, training for donning & doffing was given and a course of gait training for four week was given. Main Outcome Measures: Objective measurements of energy efficiency were obtained. The Prosthetic assessment form was used to gather subjective information from the participants. Results: The result of the present study shows statistically significant between the two groups which says that in bilateral trans-femoral amputee the metabolic cost index is quite higher than the normal able bodied. In results it was found that the VO2 uptake, Heart rate, VCO2 and Energy Expenditure per minute(EE/min) comparisons were highly significant for both bilateral trans-femoral amputee and normal able bodied in walking(p<0.05) and also in stair climbing(p<0.05) condition. Conclusions: The use of stubbies is a safe, practical and effective method of improving gait as well as less energy consumption than amputee patient in early rehabilitation program. It has also a clinically significant effect on the indoor mobility of users. These findings have implications for the standards of care and clinical use in rehabilitation program.
Transfemoral amputee, Stubbies, Prosthesis, walking, stair climbing, Energy expenditure, Physical effort, Rehabilitation
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