Prosthetic Training for Ukrainian citizens under infection isolation - a case series of four patients with lower limb amputation

Research Objectives: To assess the rehabilitation of four polytrauma patients with lower limb amputations, whilst under infection isolation.

Design: A case series.

Setting: Inpatient treatment in a specialized rehabilitation hospital in Norway.

Participants: Four patients admitted to Sunnaas Rehabilitation Hospital between January 2023 and April 2024. They had sustained polytrauma with one or more lower limb amputation in the Ukraine war, and been evacuated to Norway for medical treatment and rehabilitation.

Interventions: The patients had antimicrobial-resistant bacterial infections necessitating infection isolation. This limited access to the rehabilitation facilities available. To ensure adequate therapeutic input during the hospital stay, there was a need for additional facilitation from the hospital and health care workers. The patients received complex rehabilitation, including prosthetic gait training with microprocessor knees, in a multidisciplinary setting.

Main Outcome Measures: Functional Independence Measure (Motor subscale), 10 Meter Walk Test and patient satisfaction questionnaires.

Results: The four patients included in this study achieved independent functional gait with a prosthetic limb, and a Functional Independence Measure Motor subscale score of above 85 out of 91 (range 85-89) on discharge. 10 Meter Walk Test performed at discharge showed an average preferred walking speed of 0.93 m/s (range 0.89-1.00). The study also identifies the measures implemented for this patient group to allow additional therapeutic input and enough exercise to reach their functional goals, despite of restrictions due to infection isolation.

Conclusions: There are several challenges in providing rehabilitation for patients with amputations, under infection isolation. These challenges can be mitigated, and functional prosthetic limb use can be achieved, through a multidisciplinary team approach and facilitation. This study shows four Ukrainian patients who went through rehabilitation in Norway and achieved functional prosthetic use. It also identifies measures that can mitigate the challenges associated with infection control measures, preventing access to rehabilitation facilities.

Author(s) Disclosures: Nil.