Patient Information: Male, Age 50
Diagnosis: Below Knee Amputation
History: This gentleman was referred to a skilled nursing facility for physical and occupational therapy services after hospitalization due to a non-healing diabetic ulcer on the right foot resulting in a below the knee amputation. Prior to the amputation, he lived at home and was independent with walking and driving.
Pre-Therapy Status:
•Right Residual Limb Circumference (10 cm below knee cap): 51.5 cm.
•Bed Mobility: Moderate (50%) assistance.
•Transfers: Moderate (50%) assistance.
•Ambulation: Unable to walk.
Therapy Information:
•Modality: OmniSWD® Shortwave Diathermy System / OmniStim® FX² Pro Patterned Electrical Neuromuscular Stimulation (PENS).
•Frequency: 5x per week.
•Protocol Specifics: Subthermal shortwave diathermy to the right residual limb to increase local circulation and decrease swelling. PENS lower extremity triphasic protocol to the right quadriceps and hamstring muscles was added to his plan of care after several weeks for strengthening and neuromuscular re-education.
•Duration: Twelve weeks.
•Other Therapy Services Provided: Bed mobility, transfer training, gait training, balance activities, therapeutic exercises, prosthetic training and residual limb edema management.
Outcome:
• Right Residual Limb Circumference (10 cm below knee cap): 46.0 cm, a 10.1% reduction from baseline.
• Bed Mobility: Independent.
• Transfers: Independent.
• Ambulation: Independent for 100 feet with a rolling walker, wearing a temporary prosthesis.
This gentleman is excited about his accomplishments in therapy! He credits the diathermy with accelerating the process to begin prosthetic training. He has returned home and is able to walk at home and in the community with his rolling walker. He is continuing therapy services at an out-patient facility to progress to a permanent prosthesis.