A New Approach to Supporting Amputees
“We would like to introduce a component of amputee
rehabilitation that we have found to be extremely successful in our patient
population.”
The prevalence of limb loss in the United States in 2005 was 1.6 million and
projections for the number of amputees in coming years are startling, according
to Ziegler-Graham et al. Research shows that patients who undergo amputation
will more than double from 1.6 to 3.6 million by the year 2050, with more than
1.4 million being over the age of 65. This increase is related to the aging of
the population coupled with the number of people living with dysvascular
conditions, especially diabetes mellitus.
As physiatrists, we serve to coordinate rehabilitative services and care for
amputees. Amputee rehabilitation is a core clinical competency and is one of the
13 qualifying diagnoses for admission to acute inpatient rehabilitation. The
importance of understanding amputee care during residency is evident.
Despite the clear need of practice-based learning for amputee rehabilitation in
PM&R training programs, there is a paucity of information regarding amputee
medicine opportunities following residency at a national level. A recent search
of the AAPM&R and the Association of Academy Physiatrists’ databases revealed no
information on fellowship or post-graduate positions in this field. Given the
steady increase in the number of amputees, it is critical to raise awareness for
improved training during residency and to augment the informational resources
for options after graduation. Additionally, it would be valuable to explore more
practice-based approaches to various elements of amputee care.
In this vein, we would like to introduce a component of amputee rehabilitation
that we have found to be extremely successful in our patient population. We have
instituted a hospital-based multidisciplinary support group for all amputees in
the New York City community. The New York University Amputee Support Program
fosters an environment for social interaction with monthly meetings attended by
health care team members and amputees from the community along with their
friends and family members. An integral part of the program’s mission is to
supply members with the funding and education necessary to advocate for their
needs, including a membership with the Amputee Coalition of America.
Additionally, we plan on implementing a peer mentoring service as well as an
in-hospital educational program for new amputees; we also plan to offer
complementary medical approaches to pain control such as tai chi, yoga, and
acupuncture. We’re developing a guest lecture series in which speakers from
various disciplines educate members on many aspects of their condition. Finally,
we organize community-based activities to unite members and to encourage greater
community independence.
As coordinators of care, physiatrists are well suited to champion the cause of
social support. A study performed on our group revealed a significant
improvement in prosthetic knowledge, body image, home activities, and community
tasks following participation in support group meetings. The majority of
research performed on social support groups within medicine has been limited to
cancer patients, where results reveal that this outlet positively affects
quality of life and improves mortality. Further research examining social
support in amputee medicine will allow us to maximize patient care and
reintegration for this patient population.
Jeff Heckman, DO
PGY3 – New York University PM&R Douglas
Elwood, MD, MBA
PGY4 – New York University PM&R
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