J Korean Med Assoc.
2021 Aug;64(8):537-542. 10.5124/jkma.2021.64.8.537.
Rehabilitation of patients after diabetic foot amputation
- Affiliations
-
- 1Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- KMID: 2519077
- DOI: http://doi.org/10.5124/jkma.2021.64.8.537
Abstract
- Background
Diabetic foot is a diabetes-related complication that often requires amputation due to ulcer, necrosis, infection, and wound healing problems. Amputation decreases ambulation ability and worsens the patient’s general condition. Thus, active gait training is important after amputation.
Current Concepts
The level of amputation depends on the anatomical position, for example, toe amputation and transfemoral amputation. The impairment of ambulatory function is also determined by the position of amputation. Continuous rehabilitation exercise is encouraged for ambulation before surgery. Wound management and pain control are needed for early rehabilitation exercise after surgery. The maturation of the amputation stump is especially important and needed for prosthesis wearing. If the general condition of the patient permits, muscle strengthening exercises, joint range of motion exercises, and ambulation exercises should be started as soon as possible.
Discussion and Conclusion
Sufficient understanding of functional decline after amputation is required. The clear goal of ambulation should be set in consideration of the patient’s general condition and ability to walk before surgery. The ultimate goal of amputation is not only to remove necrosis, ulcers, and infected tissues but also to restore ambulatory function. Thus, expertise and significant effort before and after surgery are required.
