PPAM AID - PNEUMATIC POST AMPUTATION MOBILITY AID Sheila Hughes 2008
• Original design was by Professor Little from RPA in 1971. Comprised an inflatable air splint with a rigid aluminium frame and a telescopic shank and a SACH foot • In 1982 Bonner in the USA trialled a air leg which had an inner air bag that was placed over the stump and an outer fibreglass shell. Again it had a metal shank and a SACH foot.
• Research Dept at Roehamton Hospital London combined the two designs and added their own touch. • Their mobility aid comprises an aluminium frame with a rocker foot, a small inner bag which is placed over the distal stump and an outer stump sleeve which extends into the groin.
• Used for transtibial and transfemoral amputees • Use same aluminium support frame but different stump bags • Cannot be used for bilateral amputees
• Partial weight bearing aid only • Used primarily in the parallel bars • Some patients can progress to crutches but never used with sticks
• Can be used from approx 7 days post-op, dependent on initial wound healing • Accurate documentation of wound progress is essential • Never used if wound is infected or if wound is dehiscing • Can be applied over stump dressings, stump shrinkers , bandages or over trousers
Method • Pump a small amount of air into the inner bag • Turn it inwards to form a shallow cup which is then placed on the end of the stump • The larger outer stump sleeve is then slipped over the inner cushion and placed with the top end in contact with the patients groin.
• A rigid frame is then placed over the outside of the bag • Need to leave at least 2 inches between the top of the frame and the top of the outer bag.
• The webbing is placed at the bottom of the frame to support the distal end of the outer sleeve. • The rocker foot should be in a position such that the remaining limb is slightly shorter • Place strap over opposite shoulder and attach to frame.
• Support the frame whilst inflating • The outer bag is inflated to 40 mm. Hg for walking • On weight bearing there will be some shortening and some adjustment may need to be made to the length.
• Worn for 5 - 10 mins initially and then the stump must be examined • Gradually build up wearing time • Whenever the patient is sitting the outer sleeve must be deflated a little and the leg elevated to prevent the circulation being compromised
Benefits • • • Psychological boost Patient is upright and weight bearing Provides total stump contact Aids in oedema reduction Can give some indication about whether or not they will be prosthetic users • Can be reused for other amputees
Drawbacks • Lack of knee flexion/extension when mobilising • Can introduce gait deviations eg. circumduction. More apparent with transfemorals. • Initial stages are time consuming
Скачать презентацию PPAM AID — PNEUMATIC POST AMPUTATION MOBILITY AID
fb08852671339491524963215b327bf5.ppt