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2.2.1 GENERAL PHYSICAL REHABILITATION BEFORE AMPUTATION IF IT IS PLANNED AMPUTATION The patient is prepared before amputation ofthe limb ifperformance ofthe operation is planned. Exercises playa great role in healing of the stump wound and mobility after amputation. These exercises involve exercises ofthe upper limb; quadriceps drills, push ups and walking with crutches. Exercises strengthen the patient's muscles and enable the clients to practice untill competent to function independently. Gaining ofindependence is stressed even before amputation so that the patient be positive right through the process of rehabilitation. The patient is educated about general hygiene, which include bathing, dressing and use ofthe toilet (Jones, 1997:58). 2.2.2 CARE OF THE STUMP The development offunctional mobility in conjuction with daily living tasks enable the amputees to improve self-confidence and feel safe and comfortable during the rehabilitation process. Care ofthe stump is an important aspect that facilitates functional mobility. Itinvolves stump massage, which promotes blood circulation and warmth to the stump thus promoting wound healing. Exercise of the stump promotes the range of all movements to prevent stiffuess ofjoints and contractors, while coning and bandaging to shape the stump prepare it for fitting into the prosthesis. Failure to exercise the stump causes construetures of the joint above the stump, thus causing difficulty in using a prosthesis and also in performing the activities of daily living. Failure to massage the stump will cause pain followed by a reluctance to wear a prosthesis. This is because massage stimulates circulation, relieves pain and reduces phantom sensations as the patienthandles the stump (Footner, 1987:58 as cited in Siyothula & Kubheka, 2002:71). 8
2.2.3 PROSTHESIS Prior to fitting ofthe prosthesis, the patient is evaluated with regard to independence in dressing, toileting, bathing, kitchen and transfer activities. After this evaluation, training is provided ifindicated. Evaluation and treatment principles are based on the part ofthe body amputated. Independence is very important, even for those amputees who are to be fitted and trained with prostheses. Prior to and following prosthesis fitting, the development of functional mobility is essential. The prosthetist measures and fits the prosthesis according to the limb amputated and the amputee is then taught how to put it on and remove it. The amputees are also taught about the use of the prosthesis, for instance, walking with the prosthesis for lower limb amputees and writing, moving or handling ofobjects ifit is an upper limb amputee. Kubheka and Uys (1995:45) describe how care of the prosthesis is done by the prosthetist and how to keep it in a good condition to prevent injuries. If limb-fitting instructions are given correctly, a fitted modem prosthesis enables the amputee to walk in such a way that the disability can hardly be noticed. 2.2.4 WHEEL CHAIR AND CRUTCHES amputees with bilateral lower limb amputations use wheelchairs, as they cannot balance on crutches, and those with umlateral lower limb amputations use crutches initially before fitting ofthe prosthesis. The bilateral amputees are educated about the use ofthe wheelchair and are taught upper limb exercises specifically to strengthen muscles to enable them to push the wheelchair. Although with advancement in technology wheelchair are driven electronically, bilateral amputees are still to be taught about these sophisticated wheelchairs by the orthotist The unilateral amputees are also taught crutch walking and care ofcrutches, for instance, that crutcbes should always have rubber a tip to prevent slipping off and arm pads to prevent injury to the tissues where the crutch comes into contact with the body. They are also taught about wear and tear of the wheelchair as well as servicing thereof(Farrel, 1986:117). 9
Page 2 and 3: TABLE OF CONTENTS PAGE The Titlefor
Page 4 and 5: DEDICATION This dissertation is wri
Page 6: The University of Zululand for prov
Page 9 and 10: 5.1 - 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5
Page 12: CHAPTER3 THEORETICAL FRAMEWORK PAGE
Page 15 and 16: 5.9 SECTIONH: EMPLOYMENT AFTERAMPUT
Page 17 and 18: 6.5.4 6.5.4.1 6.5.42 6.5.4.3 6.5.4.
Page 19 and 20: • 1.1 INTRODUCTION CHAPTER 1 Reha
Page 22 and 23: 1.6.4 Do amputees experience physic
Page 24 and 25: 1.10 CONCLUSION In this chapter an
Page 28 and 29: 2.2.5 ACCESS TO HOME AND COMMUNITY
Page 30 and 31: 2.3 PSYCHOLOGICAL REHABILITATION Ku
Page 33 and 34: Itis the duty ofthe social worker a
Page 35 and 36: 2.5.3 STAFF A(((rUDES An examinatio
Page 37 and 38: the only solution in the study that
Page 39 and 40: small and large groups. and social
Page 41 and 42: esponsibilities in positions they o
Page 43 and 44: what muses do with and for individu
Page 45 and 46: 3.4.8 TIME Time refers to the seque
Page 47 and 48: 3.5.3 MODIFIED CONCEPTUAL FRAMEWORK
Page 49 and 50: image. In this way psychological ad
Page 51 and 52: 4.1 INTRODUcrrON In this chapter th
Page 53 and 54: as it is a useful self-report instr
Page 55: 4.6 VALIDITY Al'o'DRELIABILITY The
Page 59 and 60: caused by accidents. As far as reha
Page 61: more ofthese respondents were from
Page 64 and 65: The members ofthe rehabilitation te
Page 66 and 67: ehabilitation team, to meet other b
Page 68 and 69: Pffi'SICAL CARE This item was inclu
Page 70 and 71: used correctly. Hodkinson, Smith an
Page 72 and 73: time to be visited by old coping am
Page 74 and 75: TABLE 5.14 F1NA.l\(CIAL msroav Fina
Page 76 and 77:
5.5.8 ITEM' 19 RESPONDENTS WHO MANA
Page 78:
they were fit for their old work or
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not be effectivelyproductive atwork
Page 84 and 85:
other disabled families there is a
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5.7· SECTIONF:COMMU1'olTfYRElNfEGR
Page 89 and 90:
accessibility of the home, easy mov
Page 92 and 93:
muddy and slippery when it is raini
Page 94:
to their preVIOUS jobs or to be tra
Page 97 and 98:
are community group projects, there
Page 99 and 100:
5.11 SECTION J: REHABILITATION AIDS
Page 101 and 102:
5.11.3 ITEM 45 AVAILABLE COMMUNITY
Page 103 and 104:
Table 528 reveals that amputees exp
Page 106 and 107:
Chapter three described the theoret
Page 108 and 109:
6.5.2 OBJECTIVE TWO To evaluate phy
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• Another (4) 16% were seen by th
Page 112 and 113:
-DISABILITY GRANT The disability gr
Page 114 and 115:
TRANSPORT It is the aim ofcommunity
Page 116 and 117:
• Eleven (11) 44% amputees report
Page 118 and 119:
6.5.3.1 PHYSICAL PROBLEMS SEPTIC ST
Page 120 and 121:
DISCHARGE PREPARATION The fmdings r
Page 122 and 123:
6.5.4.3 DISCHARGE PREPARATION Th'VO
Page 124 and 125:
also be made accessible for the amp
Page 126 and 127:
IS. Mbeki, T.M 1997. White Paper On
Page 128 and 129:
BIBLIOGRAPHY 1. Brink, H. 1996. Fun
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ANNAXUREI LEITER REOUESTING PERMISS
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ANNAXURE2 PERMISSION LEITER FROM DE
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The ChiefMatron King Edward VIIIHos
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'- ANNAXURE 5 -.:') OUESTIONNAIRE F
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Psychologist o Vocational rehabilit
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14. WHO TAUGHT YOU THESE ABOVE ACTI
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17.5 Ifthis financial assistance en
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Other o Ifother, please specify: _
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31. HOME VISIT BY TIIE REHABILITATI
Page 152 and 153:
34.3 Ifno, who does the evaluation
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41.2 Does department of transport p
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