Impact models of care have on the use of the PPAM aid in Scotland.
Research type
Research Study
Full title
How do different models of care in Scotland impact on the use of the Pneumatic Post Amputation Mobility(PPAM)aid with unilateral trans-tibial amputees?
IRAS ID
148431
Contact name
Joanne Hebenton
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Research summary
It is established best practice in the United Kingdom to use an early walking aid with all patients who have undergone a leg amputation and who are proceeding with limb fitting. These devices enable early walking training which has both psychological and physiological advantages for the patient, improve recovery rates and rehabilitation outcomes.
The Pneumatic Post- Amputation Mobility (PPAM) aid is the most widely used early walking aid following below knee amputation. It is a pneumatic device that applies pressure, thus reducing swelling and preparing the residuum (stump) for limb fitting.
Current evidence recommends the use of the PPAM aid within ten days after a leg amputation. The Scottish Physiotherapy Amputee Research Group (SPARG) collects national rehabilitation data on all major leg amputations. SPARG data indicates that the proportion of patients using an early walking aid within ten days of surgery is decreasing, and it has been hypothesised that this may be due to the way the service is provided in the different centres. This study proposes to analyse two years of retrospective SPARG data specifically examining demographics, rehabilitation milestones and outcomes of patients following a single below knee amputation to determine if this is the case.
If the data demonstrates that the length of time to casting for an artificial limb is related to the use of an PPAM aid within ten days, then the second stage of the study will be to try and determine, through focused interviews with the specialist physiotherapists in each centre what the barriers to the use of the PPAM aid in the different centres are. The patients' view and experiences will be discussed at patient focus groups held at five of the centres. Online questionnaires will be sent to all of the NHS prosthetists in Scotland to establish their opinion of the importance of using the PPAM aid in preparation to casting for an artificial limb.
Linking the SPARG data to the different models of care will allow for recommendations to be made regarding the optimum PPAM aid treatment program and which model of care best supports this.REC name
Wales REC 6
REC reference
14/WA/1025
Date of REC Opinion
4 Jun 2014
REC opinion
Favourable Opinion