Occupational therapy rehabilitation of lower limb amputees in the Nigeria Armed Forces Medical Services

Abstract

Anthonette A.I. Emechete, Chidozie Emmanuel Mbada

Background and objective: Soldiers are known to always sacrifice to defend the integrity of their nation and in the process may lose limbs even their lives. Injuries resulting from war are a major cause of disablement in armed forces personnel. This paper presents the outcome of a study on the Occupational Therapy Rehabilitation Programme (OTRP) of the post-war lower limb amputees at the Armed Forces Convalescent and Rehabilitation Depot, Lagos, Nigeria. Methods: Eighty soldiers (30 with above knee amputation and 50 with below knee amputation) who were given furloughs from the military authority and had satisfactorily completed physiotherapy prosthetic ambulatory training were recruited into this pre-test and post-test study. A 3-part questionnaire dealing with prosthetic use and training, social and family and work assessment was used. OTRP involved three phases; the initial assessment and evaluation phase; the intermittent phase of sequentially pre-prosthetic stump exercises, gait training, simulated vocational and job training; and the final phase of work assessment and job placement. OTRP was carried out thrice weekly for eight weeks and outcomes were assessed at inclusion and 8th week respectively. Results: The percentage difference in pre-and-post OTRP in terms of participants’ impression, usability, satisfaction and confidence in the use of prostheses was 62.5, 62.5, 45.0 and 32.5% respectively. Prosthetic use affected the sexual life of 25% of the married participants but there was no reported change following OTRP. Following OTRP, 18.8% of the participants intended to return to their previous occupation before joining the army, 44% wanted to go school, 56.3% desired better jobs; 98.8, 75.0 and 62.5% of the participants believed they could play soccer, swim and drive a car respectively. Conclusion: Occupational Therapy Rehabilitation Programme for post-war lower limb amputees who were on prostheses had positive influence on their attitude towards prosthetic use, social and family life, and perception on return to work, sports and vocation.