Clinical Reflection – Compassion & Care for a Wonderful Amputee Patient

December 23, 2021

The team at Total Health Physio has been assisting a client with rehabilitation following a bilateral knee amputation. Rex is an older adult man who is based in South-East Melbourne.

Rex is a rare and complex case. His bilateral below-knee amputation resulted from contracting a golden staph infection during a hospital admission 2 years ago. Since then, he has spent a significant amount of time in hospital receiving inpatient rehabilitation. His recovery was further hindered by a brain bleed which caused left-sided weakness.

He contacted Total Health Physio this year for rehabilitation support. Due to Covid-19, he was discharged from in-patient rehab and unable to access outpatient rehab either. Total Health Physio was able and willing to assist Rex with his rehabilitation to help him make progress towards achieving his goals.

Initial assessment

Our initial assessment gave us an opportunity to:

  • Understand the complexities of his case
  • Establish his current capabilities
  • Discuss goals and motivations.

It was clear from our initial assessment that despite his limitations, Rex is a very determined individual. He is highly motivated and is focused on building his independence.

He had been fitted with custom-made prosthetic legs. Rex required strength and balance training in order for his prostheses be used safely. Given the interruption to his rehabilitation, this process has been compromised and he was not yet confident in using them.

With Trust, Compassion & Care we began our meaningful journey together!

Identifying challenges 

From a Physiotherapy perspective, our examination revealed deficits we could improve upon. Rex was required to learn how to mobilise with his prosthetic legs in order to be able to ambulate independently.

In order to use his prostheses in a safe and independent way, work needed to be done to improve:

  • General lower limb strength
  • Balance
  • Coordination
  • Movement
  • Motor sequencing

The reduction in his exercise capacity, in combination with his disability limitations, were significant barriers to his progress.

However, his determination and eagerness to engage in physical activity was a critical factor in helping him to overcome these barriers. In addition we believe that the motivation provided by our therapist and the companionship would also be an ally towards helping Rex achieve his goals.

Establishing goals

Rex had meaningful short-term and long-term goals, these included:

  • Improving both absolute and relative power in his arms and chest
  • Being able to compete in lawn bowls twice a week, in his wheelchair and then in his prostheses
  • To learn to use his prostheses as quickly as possible

We began working together in March this year, and the timeframe to achieve these meaningful goals was Christmas day.

Physiotherapy interventions 

Rex had engaged Total Health Physio to provide two Physiotherapy sessions per week. These sessions are covered by funding within his NDIS Plan.

His treatment includes focusing on:

  • Upper limb strength exercises
  • Improving balance, which translated into confidence of walking
  • Progressive timed exercise to improve cardiovascular fitness

We had encountered a bit of a setback as Rex is currently being fitted for new prostheses. In cases such as this, updates to prostheses are often required because the residual limbs change over time. Once his new prostheses are fitted then additional Physiotherapy work will be undertaken to further develop ambulation.

Throughout our engagement with Rex we formed a trusting relationship. Rex knew our kind and caring Physio would arrive on time and with a BIG SMILE ready to make him work hard towards achieving his goals! We look forward to the appointments as much as him.

Making progress

From the start of the year to the end Rex has been working hard within the constraints of his disability but hasn’t lost sight of his goal of walking independently with his prosthesis. .

His work with our Physiotherapist is helping him to feel focused, engaged and empowered through his own rehabilitation.

Despite the setback of needing new prostheses, he is improving his overall strength significantly. This is important work to set him up for a successful transition to walking once he has his new prostheses.

The ability to walk safely comes with so many benefits and we are working with Rex to help him achieve this goal and allow him that level of independence he is so determined to achieve. We are very inspired by Rex – he is a wonderful member of the Melbourne community.

 

Looking to the future

For many people with physical disabilities, their attitude has a significant impact on the outcomes they achieve. In this case, Rex is very determined and highly motivated which is symbiotic with our Physiotherapy work.

The successes we have had so far are very meaningful for Rex but also for our team at Total Health Physio. It is very rewarding to support someone to achieve the activities that are meaningful to them.

Do you know someone that would benefit from Physiotherapy with Trust, Compassion and Care?

We’d love to hear from you.

Over the phone, please take your time to explain your circumstances and we’ll listen to you in your own words – and only suggest working together if we can make a difference, as that’s part of Trust.

Please use our contact page to get in touch.