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Abstract
Introduction
Traumatic quadruple amputations limit daily living activities; however, the current literature regarding rehabilitation treatment for multi-limb amputations is scant. The patient showed adaptation to prosthetic fittings, acquiring a level of functional independence that enabled the patient to lead a nearly independent life.
Methods
The patient’s therapeutic intervention was divided into a pre-prosthetic phase, which consisted of functional physical adaptation to the amputation and preparation for the prostheses, and a prosthetic phase, in which different myoelectric and microprocessor limb prostheses were integrated to be used functionally. Its functional use was favored by the training with contact electromyography feedback carried out with the Biometrics E-Link System® for the upper extremities that has made it possible to obtain many grip options in a natural way, for the lower extremities the use of the intelligent passive prostheses has overcome the functional capacity achieved in this type of patients referenced in the literature who had used prostheses of previous generations such as mechanical passive prostheses.
Results
With rehabilitation, the patient showed improvements in the following scales and questionnaires (initial vs. final values): Disabilities of the Arm, Shoulder, and Hand Questionnaire; Functional Independence Measure; Berg Balance Scale; Locomotor Capabilities Index in Amputees (an assessment of overall motor capacity); and Special Interest Group in Amputee Medicine scale (an assessment of the degree of mobility).
Conclusions
The patient’s age, psychological status, and family and personal support, in addition to technical and economic resources used for next-generation prostheses adapted to this clinical case, were crucial for his progress.
The use of next-generation myoelectric and microprocessor prostheses makes it possible to achieve greater end functionality in quadruple amputees.
Proximal amputation levels present greater difficulty in achieving good functionality.
Early and intensive rehabilitation could favour and contribute towards improving psychological states.
Age, psychological status, and pain management are aspects to take into account during the rehabilitation process.
IMPLICATIONS FOR REHABILITATION
Ethical approval
The clinical research ethics committee of the Hospital Universitari General de Catalunya – GrupoQuirónSalud, accredited by the Ministry of Health, evaluated the clinical case and gave a favorable opinion for publication.
Disclosure statement
No potential conflict of interest was reported by the authors.