Ishizaka Maiko, Imai Yohei, Murata Shoko, Okazaki Tetsuya
Rehabilitation Department, Medical Treatment Corporate Foundation Hakuaikai Hakuaikai Hospital, Fukuoka, Japan.
Internal Medicine, Medical Treatment Corporate Foundation Hakuaikai Hakuaikai Hospital, Fukuoka, Japan.
Jpn J Compr Rehabil Sci. 2025 May 30;16:30-36. doi: 10.11336/jjcrs.16.30. eCollection 2025.
Ishizaka M, Imai Y, Murata S, Okazaki T. Prosthesis Rehabilitation in a Left Transfemoral Amputee with Rheumatoid Arthritis. Jpn J Compr Rehabil Sci 2025; 16: 30-36.
This report describes the rehabilitation experience of a left-sided transfemoral amputee. The patient developed rheumatoid arthritis and multiple pyogenic arthritis immediately after left transfemoral amputation; additionally, he had multiple joint dysfunction and complications of immobilization, which altered his activities of daily living (ADL). He experienced difficulties in maintaining his economic status and living in his environment.
The patient was in his 50s, and at the beginning of the intervention, upper limb joint pain due to rheumatoid arthritis, muscle weakness of the limbs and trunk, reduced exercise tolerance caused by immobilization, and ADL disturbances, including one-leg standing, made prosthetic gait training impossible. Nevertheless, the patient was young, and his physical activity had been preserved until the left transfemoral amputation. Therefore, we speculated that he could achieve a prosthetic gait by improving the complications of immobilization under appropriate rheumatoid arthritis control. Rehabilitation training was conducted to improve ADL ability in stages taking rheumatoid arthritis into consideration, and social resources were utilized. Finally, he achieved prosthetic gait ability, which was necessary for survival in his living environment, and was discharged.
Even in cases where successful prosthetic ambulation is considered difficult during lower limb amputation, it is important not to exclude a patient from prosthesis fabrication by carefully predicting residual abilities that could be acquired afterward.
石坂M、今井Y、村田S、冈崎T。类风湿关节炎左侧经股骨截肢患者的假体康复。《日本综合康复科学杂志》2025年；16: 30 - 36。
本报告描述了一名左侧经股骨截肢患者的康复经历。该患者在左侧经股骨截肢后立即患上类风湿关节炎和多发性化脓性关节炎；此外，他还存在多关节功能障碍和固定并发症，这改变了他的日常生活活动（ADL）。他在维持经济状况和生活环境方面遇到困难。
患者为50多岁，在干预开始时，由于类风湿关节炎导致上肢关节疼痛、四肢和躯干肌肉无力、固定导致运动耐力下降以及包括单腿站立在内的ADL障碍，使得假肢步态训练无法进行。然而，患者较为年轻，在左侧经股骨截肢前其身体活动能力得以保留。因此，我们推测在适当控制类风湿关节炎的情况下，通过改善固定并发症，他能够实现假肢步态。考虑到类风湿关节炎，分阶段进行康复训练以提高ADL能力，并利用社会资源。最终，他获得了在其生活环境中生存所需的假肢步态能力并出院。
即使在下肢截肢时认为成功的假肢行走困难的情况下，通过仔细预测随后可能获得的残余能力，不将患者排除在假肢制作之外也很重要。
